Drug Interaction between Cefuroxime and Ranitidine

Cefuroxime is a semisynthetic cephalosporin antibiotic used in the treatment of bacterial infections as it acts by inhibiting microbial cell wall formation.
Ranitidine is an Histamine H2 receptor blocker used in the treatment of GERD (gastroesophageal reflux disease), stomach and intestinal ulcers.

The concomitant use of both Cefuroxime and Ranitidine can lead to a major drug interaction. This is because Ranitidine, as an H2-receptor antagonists, increases gastric pH (making the stomach more alkaline), which would decrease the pH-dependent drug dissolution and absorption of Cefuroxime. Studies have revealed that there is a reduction in Cmax and AUC of Cefuroxime between 30% to 40%. This also applies when Cefpodoxime is used along with Ranitidine, due to Cefpodoxime's pH-dependent dissolution and absorption.
Generally, H2-receptor antagonists, proton pump inhibitors and antacids should be avoided with these antibiotics.

This is considered a major drug interaction in which an alternative is strongly advised.

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